Skip to main content
NCBI home page
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1982 Feb;19(1):22–25. doi: 10.1136/jmg.19.1.22

Apnoea following suxamethonium: the genetic study of four generations of a family.

A A Morgan
PMCID: PMC1048814  PMID: 7069741

Abstract

Nineteen subjects were investigated as a result of apnoea following the administration of suxamethonium occurring in one member of the family. Examination of the blood for cholinesterase activity, dibucaine number, and fluoride number was carried out and the appropriate genotype determined. The significance of the genetic variation of plasma cholinesterase in relation to suxamethonium apnoea is discussed. Five subject had the genotype Eu1Eu1, seven were of genotype Eu1E1a, three were Eu1Es1, and four Ea1Es1. Nine members of the family were considered to be at risk for the administration of suxamethonium. The appropriate action to safeguard other members of the family following a case of apnoea is outlined. By routine preoperative blood examination, 92 of 100 cases of suxamethonium apnoea resulting from a genetic abnormality of plasma cholinesterase can be anticipated.

Full text

PDF
22

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BLEISCH V. R., SHWACHMAN H. Serum cholinesterase values in childhood in health and disease. Pediatrics. 1954 May;13(5):426–438. [PubMed] [Google Scholar]
  2. BRODY S. Plasma cholinesterase activity in the newborn infant. Acta Obstet Gynecol Scand. 1960;39:1–9. doi: 10.3109/00016346009157830. [DOI] [PubMed] [Google Scholar]
  3. Berry M., Whittaker M. Incidence of suxamethonium apnoea in patients undergoing E.C.T. Br J Anaesth. 1975 Nov;47(11):1195–1197. doi: 10.1093/bja/47.11.1195. [DOI] [PubMed] [Google Scholar]
  4. CHURCHILL-DAVIDSON H. C. The changing pattern of neuromuscular block. Can Anaesth Soc J. 1961 Mar;8:91–98. doi: 10.1007/BF03021338. [DOI] [PubMed] [Google Scholar]
  5. Dabew D. Cholinesterase- und Transaminasen-Aktivität im Serum von Kindern (3 bis 6 Jahre alt) Z Klin Chem Klin Biochem. 1970 Jan;8(1):12–16. [PubMed] [Google Scholar]
  6. HARRIS H., WHITTAKER M. Differential inhibition of human serum cholinesterase with fluoride: recognition of two new phenotypes. Nature. 1961 Jul 29;191:496–498. doi: 10.1038/191496a0. [DOI] [PubMed] [Google Scholar]
  7. HUTCHINSON A. O., WIDDOWSON E. M. Cholinesterase activities in the serum of healthy British children. Nature. 1952 Feb 16;169(4294):284–285. doi: 10.1038/169284a0. [DOI] [PubMed] [Google Scholar]
  8. KALOW W., GENEST K. A method for the detection of atypical forms of human serum cholinesterase; determination of dibucaine numbers. Can J Biochem Physiol. 1957 Jun;35(6):339–346. doi: 10.1139/y57-041. [DOI] [PubMed] [Google Scholar]
  9. KALOW W., LINDSAY H. A. A comparison of optical and manometric methods for the assay of human serum cholinesterase. Can J Biochem Physiol. 1955 Jul;33(4):568–574. [PubMed] [Google Scholar]
  10. KALOW W., STARON N. On distribution and inheritance of atypical forms of human serum cholinesterase, as indicated by dibucaine numbers. Can J Biochem Physiol. 1957 Dec;35(12):1305–1320. [PubMed] [Google Scholar]
  11. KAUFMAN L., LEHMANN H., SILK E. Suxamethonium apnoea in an infant; expression of familial pseudocholinesterase deficiency in three generations. Br Med J. 1960 Jan 16;1(5167):166–167. doi: 10.1136/bmj.1.5167.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. LEHMANN H., COOK J., RYAN E. Pseudocholinesterase in early infancy. Proc R Soc Med. 1957 Mar;50(3):147–150. doi: 10.1177/003591575705000304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. LIDDELL J., LEHMANN H., DAVIES D. HARRIS AND WHITTAKER'S PSEUDOCHOLINESTERASE VARIANT WITH INCREASED RESISTANCE TO FLUORIDE. A STUDY OF FOUR FAMILIES AND THE IDENTIFICATION OF THE HOMOZGOTE. Acta Genet Stat Med. 1963;13:95–108. [PubMed] [Google Scholar]
  14. LIDDELL J., LEHMANN H., SILK E. A 'silent' pseudo-cholinesterase gene. Nature. 1962 Feb 10;193:561–562. doi: 10.1038/193561a0. [DOI] [PubMed] [Google Scholar]
  15. Pittinger C. B., Eryasa Y., Adamson R. Antibiotic-induced paralysis. Anesth Analg. 1970 May-Jun;49(3):487–501. [PubMed] [Google Scholar]
  16. Pittinger C., Adamson R. Antibiotic blockade of neuromuscular function. Annu Rev Pharmacol. 1972;12:169–184. doi: 10.1146/annurev.pa.12.040172.001125. [DOI] [PubMed] [Google Scholar]
  17. Robertson G. S. Serum cholinesterase deficiency. II. Pregnancy. Br J Anaesth. 1966 May;38(5):361–369. doi: 10.1093/bja/38.5.361. [DOI] [PubMed] [Google Scholar]
  18. Viby-Mogensen J., Hanel H. K. Prolonged apnoea after suxamethonium: an analysis of the first 225 cases reported to the Danish Cholinesterase Research Unit. Acta Anaesthesiol Scand. 1978;22(4):371–380. doi: 10.1111/j.1399-6576.1978.tb01313.x. [DOI] [PubMed] [Google Scholar]
  19. WHITTAKER M. THE PSEUDOCHOLINESTERASE VARIANTS: ESTERASE LEVELS AND INCREASED RESISTANCE TO FLUORIDE. Acta Genet Stat Med. 1964;14:281–285. doi: 10.1159/000151853. [DOI] [PubMed] [Google Scholar]
  20. Whittaker M. Plasma cholinesterase variants and the anaesthetist. Anaesthesia. 1980 Feb;35(2):174–197. doi: 10.1111/j.1365-2044.1980.tb03800.x. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES